title: Biochemical markers of bone turnover and clinical outcome in patients with renal cell and bladder carcinoma with bone metastases following treatment with zoledronic acid: The TUGAMO study.
abstract: BACKGROUND
  Levels of bone turnover markers (BTM) might be correlated with outcome in terms of skeletal-related events (SRE), disease progression, and death in patients with bladder cancer (BC) and renal cell carcinoma (RCC) with bone metastases (BM). We try to evaluate this possible correlation in patients who receive treatment with zoledronic acid (ZOL).
  
  
  METHODS
  This observational, prospective, and multicenter study analysed BTM and clinical outcome in these patients. Serum levels of bone alkaline phosphatase (BALP), procollagen type I amino-terminal propeptide (PINP), and beta-isomer of carboxy-terminal telopeptide of type I collagen (β-CTX) were analysed.
  
  
  RESULTS
  Patients with RCC who died or progressed had higher baseline β-CTX levels and those who experienced SRE during follow-up showed high baseline BALP levels. In BC, a poor rate of survival was related with high baseline β-CTX and BALP levels, and new SRE with increased PINP levels. Cox univariate analysis showed that β-CTX levels were associated with higher mortality and disease progression in RCC and higher mortality in BC. Bone alkaline phosphatase was associated with increased risk of premature SRE appearance in RCC and death in BC.
  
  
  CONCLUSIONS
  Beta-isomer of carboxy-terminal telopeptide of type I collagen and BALP can be considered a complementary tool for prediction of clinical outcomes in patients with BC and RCC with BM treated with ZOL.
authors.affiliation: Hospital Clínic i Provincial de Barcelona, Carrer Villaroel, no. 170, 08036 Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Alcaraz
authors.forename: R
authors.initials: R
authors.lastname: González-López
authors.forename: J
authors.initials: J
authors.lastname: Morote
authors.forename: C
authors.initials: C
authors.lastname: de la Piedra
authors.forename: C
authors.initials: C
authors.lastname: Meseguer
authors.forename: E
authors.initials: E
authors.lastname: Esteban
authors.forename: M
authors.initials: M
authors.lastname: Climent
authors.forename: B
authors.initials: B
authors.lastname: González-Gragera
authors.forename: J-L
authors.initials: JL
authors.lastname: Alvarez-Ossorio
authors.forename: I
authors.initials: I
authors.lastname: Chirivella
authors.forename: B
authors.initials: B
authors.lastname: Mellado
authors.forename: P-C
authors.initials: PC
authors.lastname: Lara
authors.forename: F
authors.initials: F
authors.lastname: Vázquez
authors.forename: J-A
authors.initials: JA
authors.lastname: Contreras
authors.forename: J
authors.initials: J
authors.lastname: Carles
authors.forename: A
authors.initials: A
authors.lastname: Murias
authors.forename: V
authors.initials: V
authors.lastname: Calderero
authors.forename: J
authors.initials: J
authors.lastname: Comet-Batlle
authors.forename: A
authors.initials: A
authors.lastname: González-Del Alba
authors.forename: L
authors.initials: L
authors.lastname: León-Mateos
authors.forename: A
authors.initials: A
authors.lastname: Mañas
authors.forename: J
authors.initials: J
authors.lastname: Segarra
authors.forename: A
authors.initials: A
authors.lastname: Lassa
authors.forename: C
authors.initials: C
authors.lastname: González-Enguita
authors.forename: M-J
authors.initials: MJ
authors.lastname: Méndez
authors.forename: P
authors.initials: P
authors.lastname: Samper
authors.forename: M
authors.initials: M
authors.lastname: Unda
authors.forename: I
authors.initials: I
authors.lastname: Mahillo-Fernández
authors.forename: J
authors.initials: J
authors.lastname: Bellmunt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary; D016723:Bone Remodeling; D001842:Bone and Bones / Q000201:enzymology / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000378:metabolism* / Q000401:mortality; D024042:Collagen Type I / Q000097:blood; D004164:Diphosphonates / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D011446:Prospective Studies; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000378:metabolism; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000401:mortality; D000077211:Zoledronic Acid
chemical_list: D014408:Biomarkers, Tumor; D050071:Bone Density Conservation Agents; D024042:Collagen Type I; D004164:Diphosphonates; D007093:Imidazoles; D010446:Peptide Fragments; D011347:Procollagen; C047202:procollagen Type I N-terminal peptide; D000077211:Zoledronic Acid; D000469:Alkaline Phosphatase